CCSB Call Center Representative I

Pinnacle Claims Management; Irvine (CA); On-site; USD 42,000 - 60,000; Full time

Job summary

Pinnacle Claims Management in Irvine, CA is seeking a Call Center Representative I to deliver exceptional customer service and technical support for HBEX processes. You will handle inbound calls and web inquiries, documenting interactions and maintaining HIPAA-compliant practices while meeting service metrics.

As a frontline liaison, you will build relationships with agents and counselors, stay adaptable, and continuously seek ways to improve the customer experience in a dynamic regulatory

Responsibilities

• Manage inbound calls in a timely and professional manner. Address customer inquiries, provide accurate information, and resolve issues.
• Build and maintain relationships with Agents, Certified Enrollment Counselors, and federal and state agency contacts.
• Become a subject matter expert in HBEX, State Provided Programs, and HealthCare.Gov.
• Serve as a representative of the Agent by displaying professionalism, knowledge, and discretion in all interactions with other members of the Agent's community and their customers.
• Enhance the Customer Experience by continuously looking for ways to improve the overall customer experience.
• Maintain composure, manage emotions, and avoid aggressive behavior, even in difficult situations.
• Adhere to the call center Quality Guidelines to ensure the best phone support for our callers.
• Stay adaptable in a constantly changing environment.
• Accepting criticism and handling high stress situations calmly and effectively.
• Provide telephonic and web-based outreach to assist with all aspects of the application process within the Covered California systems from sign-up to termination.
• Meet and maintain all department service metrics and performance objectives.
• Contribute to meeting contractual obligations with Covered California.
• Be open to change and embracing a variety of tasks.
• Contribute to meeting contractual obligations with Covered California.
• Demonstrate skills in time management and team building.
• Thoroughly document information, activities, and changes in the database and inquiry outcomes for accurate tracking and analysis. Be pleasant with colleagues and display a cooperative, good-natured attitude.
• Be reliable, responsible, and dependable.
• Utilize all capabilities to satisfy one mission — to enhance the competitiveness and profitability of our members. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively. Be willing to adjust efforts to ensure that work and attitude are helpful to others, be self-accountable, create a positive impact, and be diligent in delivering results.
• Maintain internet speed of 40 MB download and 10 MB upload and router with wired Ethernet.
• Maintain a HIPAA-compliant workstation and utilize appropriate security techniques to ensure HIPAA-required protection of all confidential/protected client data.
• Maintain and service safety equipment (e.g., smoke detector, fire extinguisher, first aid kit).
• All other duties as assigned.

Job description

Job Description Summary

The CCSB Call Center Representative I will be at the forefront of providing exceptional customer service and technical support. This role is responsible to work with a diverse group of stakeholders, including Covered California Certified Insurance Agents and Certified Enrollment Counselors. The Call Center Representative I will play a crucial role in assisting clients over the phone and electronically, making a real difference in their experience with the Health Benefits Exchange (HBEX).

The CCSB Call Center Representative I will be at the forefront of providing exceptional customer service and technical support. This role is responsible to work with a diverse group of stakeholders, including Covered California Certified Insurance Agents and Certified Enrollment Counselors. The Call Center Representative I will play a crucial role in assisting clients over the phone and electronically, making a real difference in their experience with the Health Benefits Exchange (HBEX).

Duties And Responsibilities

Customer Advocate

• Manage inbound calls in a timely and professional manner. Address customer inquiries, provide accurate information, and resolve issues.
• Build and maintain relationships with Agents, Certified Enrollment Counselors, and federal and state agency contacts.
• Become a subject matter expert in HBEX, State Provided Programs, and HealthCare.Gov.
• Serve as a representative of the Agent by displaying professionalism, knowledge, and discretion in all interactions with other members of the Agent's community and their customers.
• Enhance the Customer Experience by continuously looking for ways to improve the overall customer experience.
• Maintain composure, manage emotions, and avoid aggressive behavior, even in difficult situations.
• Adhere to the call center Quality Guidelines to ensure the best phone support for our callers.
• Stay adaptable in a constantly changing environment.
• Accepting criticism and handling high stress situations calmly and effectively.

Call Center Support

• Provide telephonic and web-based outreach to assist with all aspects of the application process within the Covered California systems from sign-up to termination.
• Meet and maintain all department service metrics and performance objectives.
• Contribute to meeting contractual obligations with Covered California.
• Be open to change and embracing a variety of tasks.
• Contribute to meeting contractual obligations with Covered California.
• Demonstrate skills in time management and team building.
• Thoroughly document information, activities, and changes in the database and inquiry outcomes for accurate tracking and analysis. Be pleasant with colleagues and display a cooperative, good-natured attitude.
• Be reliable, responsible, and dependable.

Other

• Utilize all capabilities to satisfy one mission — to enhance the competitiveness and profitability of our members. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively. Be willing to adjust efforts to ensure that work and attitude are helpful to others, be self-accountable, create a positive impact, and be diligent in delivering results.
• Maintain internet speed of 40 MB download and 10 MB upload and router with wired Ethernet.
• Maintain a HIPAA-compliant workstation and utilize appropriate security techniques to ensure HIPAA-required protection of all confidential/protected client data.
• Maintain and service safety equipment (e.g., smoke detector, fire extinguisher, first aid kit).
• All other duties as assigned.

PHYSICAL DEMANDS/WORKENVIRONMENT

The physical demands and work environment described here represent those that an employee must meet to successfully perform this job’s essential functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to communicate with others. The employee frequently is required to move around the office. The employee is often required to use tools, objects, and controls. This noise level in the work environment is usually moderate.